Abstract

Hypocalcemia is a common condition that is frequently encountered in laboratory and clinical settings, particularly in neonatal pediatric patients. Hypocalcemia in children is characterized by a blood calcium concentration below 2.1 mmol/L (8mg/dl) or an ionized fraction below 1.1 mmol/L (4.4mg/dl). What is the location? To determine the primary causes of hypocalcemia based on age group and to ascertain the predominant signs and symptoms associated with each cause of hypocalcemia. We conducted a cross-sectional study in Baghdad, Iraq, from April 1, 2017, to April 30, 2018. During this period, a total of 68 children with symptomatic hypocalcemia were admitted to the medical wards of the Children Welfare Teaching Hospital. The age of the patients varied between birth and 15 years. The collected data included the following variables: name, age, sex, gestational age, birth weight, consanguinity, feeding method, family history of the same disease, signs and symptoms, and any associated illnesses and anomalies. Comprehensive examinations were conducted on all patients, which involved analyzing serum levels of calcium, phosphorus, alkaline phosphatase, blood urea, creatinine, parathyroid hormone, vitamin D, magnesium, and albumin. Additionally, ultrasound scans of the abdomen were performed. However, specific cases underwent further tests, including a 24-hour collection of calcium and phosphorus, as well as X-rays of the wrist, skull, and chest. Selected cases also underwent MRI and CT scans. The majority of patients in this study had hypocalcemia at ages ranging from 1 to 5 years (28 out of 68, or 41.2%). Additionally, most of these individuals were born at full term (61 out of 68, or 89.7%), had average birth weight (62 out of 68, or 91.2%), were fed with bottles (29 out of 68, or 42.6%), and had parents who were consanguineous (52 out of 68, or 76.5%). The primary factors contributing to hypocalcemia in this study were vitamin D deficiency (19/68) (27.9%) and hypoparathyroidism (18/68) (26.5%). The predominant manifestations of hypocalcemia observed in these individuals were seizures (54/68) (79.4%) and stridor (54/68) (79.4%). The presence of carpopedal spasms and bone pain as indicators of hypocalcemia showed a strong correlation with the patient’s age group. Additionally, bone pain was found to have a significant link with the causes of hypocalcemia in this study. Congenital vitamin D deficiency and transitory hypoparathyroidism primarily manifest during the newborn and infancy stages, whereas other causes predominantly occur during the early and later stages of childhood. Rachitic alterations predominantly manifest in the age range of 1 to 5 years, accounting for 16 out of 25 cases (57.1%). The typical age range for the onset of hypocalcemia in patients is between 1 and 5 years old. The primary etiology of hypocalcemia observed in this study was attributed to a deficit in vitamin D. The prevailing clinical manifestations in these patients were seizures and stridor